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目的 探讨重症急性胰腺炎 (SAP)并发心肌损害发生的危险因素及防治措施。方法 对 38例住ICU的SAP病人的临床资料进行回顾性分析。结果 2 3例 (60 5% )并发心肌损害 ,其APACHEⅡ评分为 2 9分± 8分 ,住ICU时间平均 2 1d ,其中 1 7例 (73 9% )并发多器官功能失常综合征 (MODS) ,死亡 6例 (2 6 1 % )。无明显心肌损害的 1 5例患者APACHEⅡ评分 1 2分± 4分 ,住ICU时间平均 5d ,无 1例并发MODS或死亡。结论 SAP并发心肌损害的危险因素与疾病的严重度、既往有慢性心血管疾病有关 ;治疗应采取以保证心肌氧供需平衡为主要措施的综合治疗
Objective To investigate the risk factors and prevention and treatment of myocardial injury in severe acute pancreatitis (SAP). Methods The clinical data of 38 patients with SAP who lived in ICU were analyzed retrospectively. Results 23 cases (60.5%) had myocardial damage. The APACHE Ⅱ score was 29 ± 8 and the ICU time was 21 days. Among them, 17 (73.9%) had multiple organ dysfunction syndrome (MODS) , 6 died (2 6 1%). Fifteen patients with no significant myocardial damage had an APACHE II score of 12 ± 4 and an ICU time of 5 days on average. None of the 15 patients had MODS or died. Conclusions The risk factors of SAP complicated with myocardial damage are related to the severity of the disease and chronic cardiovascular diseases. Comprehensive treatment should be taken to ensure the balance between oxygen demand and supply of myocardial oxygen